Why do patients come to the emergency department after using cannabis?
Why do patients come to the emergency department after using cannabis?
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DOI：
10.1080/15563650.2019.1657582
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发表时间：
2019-08-27
影响因子：
3.3
通讯作者：
Monte, Andrew A.
中科院分区：
文献类型：
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作者：
Shelton, Shelby K.;Mills, Eleanor;Monte, Andrew A.
背景：美国大多数州的大麻政策自由化影响了急诊科(ED)的就诊。重要的是要了解为什么人们在使用MJ后来到急诊室，因为这种药物现在全国各地有经验和天真的人都能买到。这项研究的目的是(1)通过进行额外的图表审查来改进行政数据集方法，以描述与大麻相关的急诊室就诊；(2)了解患者在使用大麻后来到急诊室的原因；以及(3)开始了解我们对大麻可归因于急诊室就诊的理解，开始教育患者和提供者大麻的安全性。方法：我们对2012至2016年间以大麻ICD-9和10-CM编码识别的急诊进行了回顾性图表回顾。对来访进行审查，并根据预先指定的定义确定就诊是否部分归因于大麻，然后将其归类为临床投诉类别。使用描述性统计、卡方检验和T检验来解释数据。结果：约四分之一(25.74%)的有大麻ICD-CM代码的就诊者被发现至少部分与大麻有关。与整个勃起功能障碍人群相比，这些患者更多的是年轻的高加索男性(p<；.0001)。因大麻而就诊的患者更常被送往医院(p<；.0001)。与大麻有关的就诊中最常见的投诉是胃肠道和精神症状，以及醉酒。与大麻有关的就诊次数随着时间的推移而上升(p=.012)。结论：基于预先指定的定义，具有良好的评价者间可靠性，我们发现25%的带有大麻ICD-CM代码的来访者部分归因于大麻。这些发现代表了大麻使用者教育的目标领域，因为公众的看法随着时间的推移而发生变化。
Background: Cannabis (MJ) policy liberalization in a majority of US states has impacted emergency department (ED) visits. It is important to understand why people come to the ED after using MJ because the drug is now available to experienced and naive people across the country. The objectives of this study were to (1) improve upon administrative dataset methodology by performing additional chart review to describe ED visits related to cannabis, (2) understand why patients come to the ED after using cannabis, and (3) begin to inform our understanding of cannabis-attributable ED visits to start to educate patients and providers about cannabis' safety. Methods: We performed a retrospective chart review of ED visits identified by cannabis ICD-9 and 10-CM codes between 2012 and 2016. Visits were reviewed and determined if the visit was partially attributable to cannabis based upon a pre-specified definition, then categorized into clinical complaint categories. Descriptive statistics, Chi-Square, and T-tests were used to elucidate the data. Results: About one-fourth (25.74%) of visits with cannabis ICD-CM codes were found to be at least partially attributable to cannabis. These patients are more often young, Caucasian males when compared to the overall ED population (p < .0001). Patients with a cannabis-attributable visit were more often admitted to the hospital (p < .0001). The most common complaints in cannabis-attributable visits were gastrointestinal and psychiatric complaints, as well as intoxication. The number of cannabis-attributable visits rose with time (p=.012). Conclusions: Based on a pre-specified definition, with good inter-rater reliability, we found that 25% of visits with a cannabis ICD-CM code were partially attributable to cannabis. These findings represent areas to target in cannabis user education as public perceptions change across time.